Internalizing disorders and quality of life in adolescence: evidence for independent associations

Objective: To investigate whether internalizing disorders are associated with quality of life (QoL) in adolescents, even after accounting for shared risk factors. Methods: The sample comprised 102 adolescents from a community cross-sectional study with an oversampling of anxious subjects. Risk factors previously associated with QoL were assessed and divided into five blocks organized hierarchically from proximal to distal sets of risk factors. Results: Multiple regression analysis yielded a hierarchical model accounting for 72% of QoL variance. All blocks were consistently associated with QoL (p < 0.05), accounting for the following percentages of variance: 12% for demographics; 5.2% for family environment; 37.8% for stressful events; 10% for nutritional and health habits; and 64.2% for dimensional psychopathological symptoms or 22.8% for psychiatric diagnoses (dichotomous). Although most of the QoL variance attributed to internalizing symptoms was explained by the four proximal blocks in the hierarchical model (43.2%), about 21% of the variance was independently associated with internalizing symptoms/diagnoses. Conclusions: QoL is associated with several aspects of adolescent life that were largely predicted by our hierarchical model. Our findings reinforce the hypothesis that internalizing disorders and internalizing symptoms in adolescents have a high impact on QoL and deserve proper clinical attention. .

Associations between child disciplinary practices and bullying behavior in adolescents / Associações entre práticas de disciplina infantil e comportamento de bullying em adolescentes

OBJECTIVE: to investigate associations between different types of child disciplinary practices and children and adolescents' bullying behavior in a Brazilian sample. METHODS: cross-sectional study, with a school-based sample of 10-to 15-year-old children and adolescents. Child disciplinary practices were assessed using two main subtypes: power-assertive and punitive (psychological aggression, corporal punishment, deprivation of privileges, and penalty tasks) and inductive (explaining, rewarding, and monitoring). A modified version of the Olweus Bully Victim Questionnaire was used to measure the frequency of bullying. RESULTS: 247 children and adolescents were evaluated and 98 (39.7%) were classified as bullies. Power-assertive and punitive discipline by either mother or father was associated with bullying perpetration by their children. Mothers who mostly used this type of discipline were 4.36 (95% CI: 1.87-10.16; p < 0.001) times more likely of having a bully child. Psychological aggression and mild forms of corporal punishment presented the highest odds ratios. Overall inductive discipline was not associated with bullying. CONCLUSIONS: bullying was associated to parents' assertive and punitive discipline. Finding different ways of disciplining children and adolescents might decrease bullying behavior. .

OBJETIVO: investigar a associação entre práticas parentais de disciplina e comportamento de bullying entre adolescentes brasileiros. MÉTODOS: estudo transversal, com alunos de 10 a 15 anos. Práticas parentais de disciplina foram avaliadas utilizando duas subclassificações principais: autoritárias e punitivas (agressão psicológica, punição corporal, retirada de privilégios e penalidades) e indutivas (explicações, recompensa e monitoramento). Uma versão modificada do Olweus Bully Victim Questionnaire foi utilizada para verificar a frequência de bullying. RESULTADOS: foram avaliados 247 adolescentes, e 98 (39,7%) deles foram classificados como agressores. Práticas parentais de disciplina autoritárias e punitivas, utilizadas tanto pela mãe como pelo pai, apresentaram associação com a prática de bullying pelos filhos. Mães que mais utilizavam este tipo de disciplina apresentaram chance 4,36 (IC95%: 1,87-10,16; p < 0,001) vezes maior de ter um filho agressor. Agressão psicológica e formas brandas de punição corporal apresentaram os maiores odds ratio. Disciplina indutiva como um todo não apresentou associação. CONCLUSÕES: a prática de bullying apresentou associação com a disciplina parental autoritária e punitiva. A utilização de diferentes formas de disciplinar os adolescentes podem diminuir o comportamento de bullying. .

Internalizing disorders and quality of life in adolescence: evidence for independent associations.

OBJECTIVE: To investigate whether internalizing disorders are associated with quality of life (QoL) in adolescents, even after accounting for shared risk factors. METHODS: The sample comprised 102 adolescents from a community cross-sectional study with an oversampling of anxious subjects. Risk factors previously associated with QoL were assessed and divided into five blocks organized hierarchically from proximal to distal sets of risk factors. RESULTS: Multiple regression analysis yielded a hierarchical model accounting for 72% of QoL variance. All blocks were consistently associated with QoL (p < 0.05), accounting for the following percentages of variance: 12% for demographics; 5.2% for family environment; 37.8% for stressful events; 10% for nutritional and health habits; and 64.2% for dimensional psychopathological symptoms or 22.8% for psychiatric diagnoses (dichotomous). Although most of the QoL variance attributed to internalizing symptoms was explained by the four proximal blocks in the hierarchical model (43.2%), about 21% of the variance was independently associated with internalizing symptoms/diagnoses. CONCLUSIONS: QoL is associated with several aspects of adolescent life that were largely predicted by our hierarchical model. Our findings reinforce the hypothesis that internalizing disorders and internalizing symptoms in adolescents have a high impact on QoL and deserve proper clinical attention.

Associations between child disciplinary practices and bullying behavior in adolescents.

OBJECTIVE: to investigate associations between different types of child disciplinary practices and children and adolescents' bullying behavior in a Brazilian sample. METHODS: cross-sectional study, with a school-based sample of 10- to 15-year-old children and adolescents. Child disciplinary practices were assessed using two main subtypes: power-assertive and punitive (psychological aggression, corporal punishment, deprivation of privileges, and penalty tasks) and inductive (explaining, rewarding, and monitoring). A modified version of the Olweus Bully Victim Questionnaire was used to measure the frequency of bullying. RESULTS: 247 children and adolescents were evaluated and 98 (39.7%) were classified as bullies. Power-assertive and punitive discipline by either mother or father was associated with bullying perpetration by their children. Mothers who mostly used this type of discipline were 4.36 (95% CI: 1.87-10.16; p<0.001) times more likely of having a bully child. Psychological aggression and mild forms of corporal punishment presented the highest odds ratios. Overall inductive discipline was not associated with bullying. CONCLUSIONS: bullying was associated to parents' assertive and punitive discipline. Finding different ways of disciplining children and adolescents might decrease bullying behavior.

A randomized clinical trial of cognitive-behavioral group therapy and sertraline in the treatment of obsessive-compulsive disorder.

BACKGROUND: Cognitive-behavioral group therapy (CBGT) and serotonin reuptake inhibitors have proven efficacy in reducing symptoms of obsessive-compulsive disorder (OCD). There is no consensus about which of these forms of treatment is more effective. This study was conducted to evaluate the efficacy of CBGT as compared to that of sertraline in reducing OCD symptoms. METHOD: Fifty-six outpatients with an OCD diagnosis, according to DSM-IV criteria, participated in the randomized clinical trial: 28 took 100 mg/day of sertraline and 28 underwent CBGT for 12 weeks. Efficacy of treatments was rated according to the reduction in scores on the Yale-Brown Obsessive Compulsive Scale (YBOCS) and the Clinical Global Impressions-Severity of Illness scale. The trial was performed in 4 successive periods from March 2002 to December 2003. RESULTS: Both treatments were effective, although patients treated with CBGT obtained a mean YBOCS reduction of symptoms of 44%, while those treated with sertraline obtained only a 28% reduction (p = .033). Cognitive-behavioral group therapy was also significantly more effective in reducing the intensity of compulsions (p = .030). Further, 8 patients (32%) treated with CBGT presented a complete remission of OCD symptoms (YBOCS score < or = 8) as compared to only 1 patient (4%) among those who received sertraline (p = .023). CONCLUSION: Cognitive-behavioral group therapy and sertraline have shown to be effective in reducing OCD symptoms. Nevertheless, the rate of symptom reduction, intensity reduction of compulsions, and percentage of patients who obtained full remission were significantly higher in patients treated with CBGT.